Housing and economic insecurity leads to decreased rates of tympanostomy tube placement

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-07-25 DOI:10.1016/j.ijporl.2025.112502

Allison Epstein , Jamil Hayden , Ross Rosen , Emily Youner , Todd Otteson

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引用次数: 0

Abstract

Objectives

To assess socioeconomic differences in tympanostomy tube (TT) placement for pediatric patients with otitis media (OM). The primary objective is to determine if there is a lower rate of TT placement for children with OM and housing and economic insecurity (HEI). The secondary objective was to assess rates of concurrent speech delay at time of TT placement.

Methods

The TriNetx Analytics Network was queried using CPT and ICD-10 codes for pediatric patients with a history of OM. An analysis using propensity-matched cohorts was performed to assess the relationship between HEI and the rates of TT placement, and speech delay.

Results

A total of 1,978,773 pediatric patients with OM were identified. Of those, 13,030 patients were identified as having HEI. After matching by demographics, patients with HEI were less likely to undergo TT placement than those without HEI (2.93 % vs. 6.15 %, p < 0.001). Housing insecurities had the greatest association with decreased TT placement (OR 0.449, 95 % CI 0.362,0.557), followed by transportation insecurities (OR 0.545, 95 % CI 0.39,0.762) and financial insecurities (OR 0.907, 95 % CI 0.691, 1.193). Patients with HEI had higher odds of having speech delays prior to TT placement (OR 1.8171, p < 0.0001) rather than those without HEI.

Conclusions

Patients with housing and economic insecurity have significantly lower rates of tympanostomy tube placement after otitis media, but higher rates of speech delay prior to tympanostomy tube placement.

Level of evidence

Level 1.

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住房和经济不安全导致鼓室造瘘管置入率下降

目的评价小儿中耳炎（OM）患者鼓膜造瘘管（TT）放置的社会经济差异。主要目标是确定OM和住房和经济不安全（HEI）儿童的TT安置率是否较低。第二个目的是评估TT放置时并发语言延迟的比率。方法采用CPT和ICD-10代码查询TriNetx分析网络中有OM病史的儿科患者。使用倾向匹配队列进行分析，以评估HEI与TT放置率和语言延迟之间的关系。结果共发现小儿OM患者1,978,773例。其中，13030名患者被确诊为HEI。经人口统计学匹配后，HEI患者接受TT安置的可能性低于非HEI患者(2.93% vs. 6.15%, p <；0.001)。住房不安全感与TT置置度下降的相关性最大（OR 0.449, 95% CI 0.362,0.557），其次是交通不安全感（OR 0.545, 95% CI 0.39,0.762）和金融不安全感（OR 0.907, 95% CI 0.691, 1.193）。高智商患者在TT安置前出现语言迟缓的几率更高(OR 1.8171, p <；0.0001)，而非HEI。结论住房和经济不安全的中耳炎患者中耳炎后置放鼓膜管的比例较低，但中耳炎后置放鼓膜管前言语迟缓的比例较高。证据等级：1级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.